Bhat Ramitha R, Batra Prerna, Sachan Ravi, Singh Gurbachan
Senior Resident, Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India.
Professor, Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi, India.
Trop Doct. 2020 Jul;50(3):266-270. doi: 10.1177/0049475520927626. Epub 2020 May 31.
Ventriculitis after meningitis is a serious complication in the neonatal age group. The role of intraventricular antibiotics in treatment is controversial. We present five such cases which were refractory to conventional intravenous antibiotic therapy, had persistent features of ventriculitis and in whom raised intracranial pressure (ICP) necessitated insertion of an external ventricular drain (EVD). Three of the five infants required intraventricular antibiotics but also developed EVD-related complications. Early diagnosis of ventriculitis and treatment is necessary to avoid a fatal outcome. Intravenous antibiotics are the treatment of choice, but intraventricular therapy may be considered in refractory cases. As the incidence of EVD-associated ventriculitis is high, proper care of EVDs and their early removal is mandatory.
脑膜炎后的脑室炎是新生儿年龄组中的一种严重并发症。脑室内使用抗生素在治疗中的作用存在争议。我们呈现了五例这样的病例，这些病例对传统静脉抗生素治疗无效，具有持续性脑室炎特征，并且颅内压升高使得必须插入外部脑室引流管（EVD）。五名婴儿中有三名需要脑室内使用抗生素，但也出现了与EVD相关的并发症。早期诊断和治疗脑室炎对于避免致命后果是必要的。静脉使用抗生素是首选治疗方法，但对于难治性病例可考虑脑室内治疗。由于与EVD相关的脑室炎发生率很高，必须妥善护理EVD并尽早拔除。
